When Should I Be Worried That I Have a Fertility Issue?

Reproductive Endocrinologist Deborah Smith, MD, and our fertility specialists at Rocky Mountain Fertility Center in Parker and Englewood, Colorado, have more than 25 years of experience diagnosing and treating infertility.

Their medical expertise is complemented by the most advanced technology available and genuine compassion for people struggling to accomplish their dream of having a baby.

Read what these professionals recommend regarding an infertility evaluation and factors to consider before scheduling an appointment.

Calculating the odds

Not every fertile couple can get pregnant within one, six, or even 12 months of having regular sexual intercourse without birth control. 

About 20% of fertile couples under age 35 achieve pregnancy during their first cycle, and 80% are successful at six months. By one year, 90% of people who wish to become pregnant have done so.

An infertility evaluation isn’t usually recommended unless you’ve been unable to achieve pregnancy after a year of actively trying. Thus, if you’ve only been attempting to conceive for a few months and are generally healthy, you may not need a comprehensive infertility evaluation yet.

But we generally recommend that you check in with your gynecologist for a routine evaluation if you’ve been trying to conceive for more than six months without success.  

Exceptions to the one-year rule

Age is definitely a qualifying factor and an exception to the one-year rule for women regarding fertility.

On average, women in their 20s have a 25% chance of becoming pregnant during each menstrual cycle. Unfortunately, that chance drops to about 5% by the time you’re 40 due to sharp declines in viable eggs.

If you’re between 35 and 40 and haven’t conceived after six months, it’s time to schedule an evaluation. If you’re over 40, consider an assessment after 3 months of  attempting pregnancy.

Ovulation induction, in vitro fertilization (IVF), and other Rocky Mountain Fertility Center therapies can help women with low egg reserves achieve a healthy pregnancy.

Male fertility also declines with age but not as predictably as female fertility.

Also, consider an infertility evaluation sooner rather than later if you or your partner have a history of:

• Low or abnormal sperm count
• Polycystic ovarian syndrome
• Thyroid disorder
• Endometriosis
• Pelvic inflammatory disease
• Uterine fibroids
• Cervical polyps
• Previous pelvic surgery
• Abnormal menses
• Recurrent pregnancy loss
• Cryosurgery to the cervix due to an abnormal pap smear

Many of these issues are correctable with fertility treatments but can delay pregnancy, so you may benefit significantly from starting an infertility evaluation before the one-year norm.

What is involved in an infertility evaluation?

An infertility evaluation at Rocky Mountain Fertility Center is comprehensive.

For the male partner, we obtain a complete semen analysis that includes an assessment of:

• Measure in milliliters of the amount of semen ejaculated
• Sperm count or concentration of sperm in a milliliter of semen
• Sperm motility/movement
• Total number of moving sperm in a sample
• Quality of sperm motility
• Sperm morphology, evaluation of size and shape of sperm

For women, after a thorough discussion of your menstrual history and other factors pertinent to reproductive health, the first step typically includes an evaluation of your ovarian function.

This may include:

• Ultrasound evaluation of the pelvic structures
• Anti-mullerian hormone, FSH, and estradiol blood tests
• Ultrasound to determine the antral follicle count

You may require further hormone studies, imaging scans, or other evaluations based on those results. 

Schedule a visit today for more information about the services we offer at Rocky Mountain Fertility Center. Call one of our offices or request an appointment online.